Clinical Report: Recurrent Cardiac Arrests from Pulseless Electrical Activity Linked to Coronary Vasospasm

Overview

This case report details recurrent pulseless electrical activity arrests in a postoperative patient attributed to coronary vasospasm. The diagnosis was supported by transient ischemic ECG changes, nonobstructive coronary angiography, and rapid improvement with vasodilator therapy.

Background

Coronary vasospasm is a significant but often overlooked cause of myocardial ischemia and cardiac arrest, particularly in postoperative and critically ill patients. Its presentation can be subtle, often misattributed to other conditions, making early recognition crucial.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• Coronary vasospasm can mimic acute coronary syndromes and lead to life-threatening instability.
• Transient ischemic ECG changes and absence of obstructive coronary disease are key indicators for diagnosis.
• Vasospasm is highly reversible with appropriate vasodilator therapy.
• Invasive coronary functional testing is the gold standard but often contraindicated in unstable patients.

Clinical Implications

Clinicians should maintain a high index of suspicion for coronary vasospasm in postoperative patients presenting with cardiac instability.

Conclusion

This case highlights the importance of recognizing coronary vasospasm as a potential cause of cardiac arrest in critically ill patients.

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